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The development of a comorbidity index with physical function as the outcome
Abstract
Background and objectives Physical function is an important measure of success of many medical and surgical interventions. Ability to adjust for comorbid disease is essential in health services research and epidemiologic studies. Current indices have primarily been developed with mortality as the outcome, and are not sensitive enough when the outcome is physical function. The objective of this study was to develop a self-administered Functional Comorbidity Index with physical function as the outcome.Methods The index was developed using two databases: a cross-sectional, simple random sample of 9,423 Canadian adults and a sample of 28,349 US adults seeking treatment for spine ailments. The primary outcome measure was the SF-36 physical function (PF) subscale.Results The Functional Comorbidity Index, an 18-item list of diagnoses, showed stronger association with physical function (model R(2) = 0.29) compared with the Charlson (model R(2) = 0.18), and Kaplan-Feinstein (model R(2) = 0.07) indices. The Functional Comorbidity Index correctly classified patients into high and low function, in 77% of cases.Conclusion This new index contains diagnoses such as arthritis not found on indices used to predict mortality, and the FCI explained more variance in PF scores compared to indices designed to predict mortality.
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“We measured co-morbidities that are included in the Functional Co-morbidity Index (9) and have previously been reported to be highly correlated to the physical function component of the SF-36.(10)”
From Urinary incontinence and disability in community-dwelling women: A cross-sectional study: Urinary Incontinence and Disability in Ambulatory Women (2015) · cites this paper as [9]
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Metadata
- Authors
- GROLL, D., TO, T., BOMBARDIER, C., & WRIGHT, J.
- Affiliations
- Queen's University (CA)
- University of Toronto (CA)
- Institute for Work & Health (CA)
- Corresponding author
- GROLL, D
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2005-06
- Volume
- 58
- Issue
- 6
- Pages
- 595-602
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W1971721633
- Cited by
- 1,198
- References
- 53
- Citations by year
- 2026: 48 · 2025: 75 · 2024: 62 · 2023: 82 · 2022: 84 · 2021: 92 · 2020: 90 · 2019: 71 · 2018: 59 · 2017: 70 · 2016: 81 · 2015: 75 · 2014: 75 · 2013: 48 · 2012: 43
- FWCI
- 6.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Canada
- Canadian Arthritis Network
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- comorbidity index, physical function, Functional Comorbidity Index, SF-36 physical function, Charlson Comorbidity Index, arthritis, spinal disorders
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Health Status Indicators, Humans, Male, Middle Aged, Osteoporosis, Spinal Diseases, Comorbidity, Databases, Factual, Outcome Assessment, Health Care, Focus Groups, Recovery of Function
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